6 Tips for Runners with Asthma

Running and asthma would seem to be mutually exclusive, but look no further than marathon-world-record holder Paula Radcliffe of Great Britain, who was diagnosed with exercised-induced asthma at the age of 14, to see that it’s possible for asthmatics to enjoy—and excel at—a cardio-intensive sport like running.

Make Sure It’s Asthma

Just because you wheeze or cough doesn’t mean you have asthma. “There are several things that can mimic asthma, the most common being vocal-cord dysfunction,” says Roberts. “I see a lot of that, especially in younger runners who are assumed to have asthma because they have a wheezing-like sound.” See your physician for a diagnosis to ensure proper treatment.

Take Your Meds

Asthma medications work by relaxing the muscles around your airways. It’s when these muscles constrict (an occurrence known as bronchospasm) that asthmatics experience wheezing, coughing, and difficulty breathing.

Quick-relief asthma medications such as Albuterol, which are often prescribed as rescue inhalers—so called because they are designed to ease symptoms within minutes—can also be used as prophylactic or preventive medication, says Roberts. So, runners with asthma can take a dose as directed a few minutes before a run to help manage symptoms.

If you have chronic asthma (that is, your symptoms aren’t triggered solely by physical exertion), you’ll probably need to be on a daily control medication, like an inhaled steroid, in addition to having a rescue inhaler.

Warm Up

Some asthmatic runners may skip a warm-up—thinking that doing so will save their lung power for their race or workout—but, as it happens, getting your lungs working hard beforehand may actually help you avoid an attack. “There’s a refractory period for bronchospasm,” says Roberts. “If you do a warm-up hard enough to induce some coughing or wheezing, it usually takes about four to six hours before you have as bad a spasm again.”

The key is to warm up just hard enough to get a small spasm without sapping your energy. Roberts suggests running for a few minutes, then doing several short, hard pickups (bursts of faster-paced running).

Protect Against Pollen

Pollen allergies can trigger asthma symptoms for some sufferers of exercise-induced asthma, so it’s smart to run when pollen counts are at their lowest, which is usually in the early morning. Roberts also recommends checking your local pollen count online (try weatherunderground.com or pollen.com) and running on the days when the count is lowest. Afterward, shower as soon as possible to get the pollen off your hair and skin, and toss your workout clothes directly into the hamper.

If the pollen count is high even in the morning, do what Roberts does: Consider substituting an indoor activity for running, or doing something outdoors that doesn’t make you breathe as hard, such as kayaking, biking, or walking.

Cover Your Face

Even people without asthma find themselves coughing during runs in cold temperatures. Why? Breathing cold, dry air results in cold, dry airways—a trigger for bronchospasm.

Roberts suggests covering your nose and mouth while running so the moist air you exhale will help humidify the air you inhale. Stay away from cotton bandanas, which can freeze against your face in cold temperatures. “Fleece balaclavas or neck gaiters are probably the best,” Roberts says. “They maintain a fair amount of warmth even when they’re wet, and they’ll stay thawed pretty easily.”

Be Smart

* Always carry your rescue inhaler. And not just while running. “There’s no reason not to have it,” Roberts says. “You can slip it in a lot of places, like the pockets in running shorts.” You may never need to use your rescue, but if you do, you’ll be very glad you have it.

* Have a game plan. Confirm with your doctor the steps you should take if you have an asthma attack. Should you call the doctor’s office so they can determine the severity of the attack? Or should you see if you can get relief from your rescue inhaler? Create an action plan that both you and your doctor are comfortable with.

Roberts’ advice for when you get into trouble: “You want to clear this with your physician, but what I tell my patients to do is to take as many puffs of your inhaler as it requires to stop the attack, or until you start to shake so much [a side effect of the medication] that you can’t hold your inhaler. For some people, that’s four to six puffs every five minutes for several minutes. I start shaking after two puffs.”

* Consider wearing a medical alert tag. A bracelet or tag that indicates you have asthma can save first responders valuable time. “Giving the right medication quickly could be lifesaving,” says Roberts.

* Take extra precautions if you have severe asthma. If you’ve ever had what Roberts calls a “flash attack,” in which you quickly go from feeling good to being in severe distress, you should either run with a friend or carry your cell phone—or both.